Audit of Antibiotic Prophylaxis Practices in Urogynecological Surgeries and Their Impact on Postoperative Infection Rates

Abstract

Background: Postoperative infections remain a significant cause of morbidity following urogynecological surgeries, while variations in antibiotic prophylaxis practices may influence infection outcomes.

Objective: To evaluate antibiotic prophylaxis practices in urogynecological surgeries and determine their impact on postoperative infection rates.

Methods: This clinical audit was conducted at Tertiary Care Hospital from January 2025 to August 2025, included 355 patients undergoing urogynecological surgeries. Data regarding demographic characteristics, surgical variables, antibiotic prophylaxis practices, and postoperative infectious outcomes were collected using a structured proforma. Patients were evaluated for adherence to guideline-based antibiotic prophylaxis, including timing, antibiotic selection, dose, and duration.

Results: Appropriate antibiotic prophylaxis was observed in 248 (69.9%) patients, while 107 (30.1%) received inappropriate prophylaxis. Overall postoperative infections occurred in 43 (12.1%) patients. Infection rates were significantly lower in patients receiving appropriate prophylaxis compared with inappropriate prophylaxis (8.1% vs 21.5%, p=0.002). Inappropriate prophylaxis (Adjusted OR 2.74, 95% CI 1.42–5.31), prolonged operative duration (Adjusted OR 2.19, 95% CI 1.14–4.18), and prolonged catheterization (Adjusted OR 2.46, 95% CI 1.21–4.97) were independent predictors of postoperative infection.

Conclusion: Appropriate antibiotic prophylaxis practices were significantly associated with lower postoperative infection rates in urogynecological surgeries.